Postoperative complications after vacuum-assisted excision of benign breast tumors and their associated risk factors

This study aims to investigate the incidence of postoperative complications following vacuum-assisted excision (VAE) of benign breast tumors and identify the associated risk factors, in order to support clinical risk assessment and perioperative management. A retrospective review was conducted of 100 female patients who underwent ultrasound-guided VAE for benign breast lesions at our institution between December 2023 and December 2024. Patients were categorized into a complication group (n = 30) and a non-complication group (n = 70) based on the occurrence of complications within 30 days postoperatively. Clinical and procedural characteristics were compared between the 2 groups. Univariable and multivariable logistic regression analyses were performed to identify independent risk factors. A predictive model was established and evaluated using the receiver operating characteristic curve and calibration curve. A nomogram was constructed for individualized risk prediction. The overall 30-day complication rate was 30.00%. The most common complications were hematoma (12.00%), subcutaneous ecchymosis (11.00%), pain (9.00%), skin depression (5.00%), and wound infection (1.00%). Univariable analysis indicated that tumor size, number of lesions, distance from the skin, surgeon experience, and compression time were significantly associated with postoperative complications (P < .05). Multivariable analysis identified tumor size (odds ratio [OR] = 2.12, 95% CI: 1.12-4.00), distance from the skin <5 mm (OR = 2.62, 95% CI: 1.08-6.35), compression time <10 minutes (OR = 2.80, 95% CI: 1.18-6.63), and surgeon experience <3 years (OR = 2.42, 95% CI: 1.02-5.73) as independent risk factors. The model demonstrated good discriminative ability (area under the curve = 0.826, 95% CI: 0.732-0.921) and acceptable calibration (Hosmer-Lemeshow P = .239). The nomogram provided an intuitive visualization for individualized complication-risk prediction. Complications after VAE for benign breast tumors are relatively common, with hematoma, ecchymosis, and pain being the most frequent. Larger tumors, superficial lesions, insufficient postoperative compression, and limited surgeon experience significantly increase the risk of complications. The prediction model and nomogram offer a practical tool for individualized perioperative risk assessment and complication prevention.